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Application for Business License

Revised January 2010

(To be accomplished in duplicate)
Application Form for Business
Tax Year _________
Cagayan de Oro City


Date of Application: DTI / SEC Registration/Date

Reference No./Current Permit No. TIN
Kind of Ownership: ( ) Single Proprietor ( ) Partnership ( ) Corporation ( ) Others _____________
Are you enjoying tax incentive from any Government Entity?
( ) Yes ( ) No Pls. specify the entity.
Last Name First Name Middle Name

Name of Applicant:

Name of Spouse:
Business Name
Name of Representative
Business Address Owner’s Address
House No. and Street House No. and Street

Barangay: Barangay:
Tel. No. (Land Line): Tel. No. (Land Line)
Tel. No. ( Mobile): Tel. No. ( Mobile)
eMail Address: eMail Address
Property Index No. (PIN) Property Index No. (PIN)
Business Area (in sq.m.) Total No. of Employees Do you have a Privately Owned Warehouse?.
( ) Yes ( ) No - Please Indicate Location

If the place of business is rented, please

identify the following
Name of Bldg./Lessor:
Address of Lessor:
Tel. No. of Lessor:
Amount of Monthly Rental:

Code Nature of Business No. of Capital Gross Sales/Receipts
Units/Branches (For New) Essential (For Renewal) Non-Essential

I HEREBY SWEAR to the correctness and accuracy of the information that are presented above and understand that I will comply with the
following conditions in order to continue to operate the above described business activity, to wit:

1. Pay all taxes and fees appurtenant to my business under existing ordinances.
2. Comply with the pertinent provisions of Ord. No. 4373-94 and Ord. No. 8847-2003 and other related rules and regulations.
3. Exercise due care and diligence in maintaining hygiene and sanitation in my business establishment.
4. Exhibit my Business Permit as well as pertinent official receipts relative to the payment of licenses, fees and/or taxes, in a conspicuous place
visible to the public within my establishment.
5. Submit a copy of my Income Tax Return, together with an audited Financial Statement , on or before April 20 of each Taxable Year.
6. Observe, when and where applicable, the requirement of the Social Security System (SSS) PhilHealth, Pag-IBIG, National Food Authority and
National Internal Revenue Code.
7. Comply with the requirements of the National Building Code and the requirement of the City Fire Department.

I SWEAR FURTHER that I will undertake to correct whatever deficiencies in the compliance of the requirement of the City Fire, Building,
Zoning, PhilHealth, BIR, SSS, Pag-IBIG and other Departments/Offices and Agencies concerned, in their post licensing evaluation/monitoring of my
business establishment during the taxable year and/or within thirty (30) days from the issuance of my Business Permit, which can be revoked by the
Office of the City Mayor, for non-compliance of any of the above conditions.

Signature of Applicant/Taxpayer

SUBSCRIBED AND SWORN TO before me this _______day of ____________________, 20___ at the City of Cagayan de Oro, Philippines,
Affiant exhibited to me his/her Community Tax Certificate No. ________________________issued on ________________________at

Doc. No._________
Page No. ________
Book No. ________
Series of 20___



City Treasurer City Mayor